Contact Us

1.877.607.9333

Send us an email!

Contact details:

Message:

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Car insurance Quote

Your car:

Do you want to include another Car?

Driver(s) details:

Contact Information

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House insurance Quote

Your house:

Insurance Amount $

Basement

Basement No Basement

Security Information

Fire Alarm

Fire Alarm No File Alarm

Burglar Alarm

Burglar Alarm No Burglar Alarm

Are exterior doors equipped with deadbolt locks?

Yes No

Applicant Information:

Do you currently have a home insurance policy?

Yes No
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Business insurance Quote

Level of protection: $

Contact details:

Travel

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Life insurance Quote

Level of protection: $

Contact details:

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Privacy Statement

PERSONAL INFORMATION CLIENT CONSENT FORM
As part of my application for insurance, I hereby consent to the brokerage firm
“Advanced Insurance Brokers Inc.” collecting, using and disclosing personal information
required for purposes of considering my application for new or renewal property/casualty
and/or automobile and/or other insurance coverage.
“Advanced Insurance Brokers Inc” is authorized to collect, use, and disclose personal
information to third parties, as required, including insurance companies. “Advanced
Insurance Brokers Inc” may also be required or permitted to disclose such personal
information pursuant to the relevant privacy laws or other laws.
If I wish to review personal information pertaining to my application or policy maintained
by “Advanced Insurance Brokers Inc”, obtain copies of the Broker’s privacy policies or
standards, or make other enquiries or express concerns, I understand that I may do so
by contacting “Advanced Insurance Brokers Inc”’ privacy officer.
I agree that all the personal information provided to “Advanced Insurance Brokers Inc”
Will be complete and accurate.

Our Location

Advanced Insurance Brokers Inc.

2-825 Park Ave W
Chatham, Ontario N7M0N1

Contact details

E-mail address:
yourteam@advancedinsurancebrokers.com

1.877.607.9333

Office Hours : By Appointment only

We are here to help whatever your situation!

Send us an email!

Close this notice.